MetaSense Inc
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Key Responsibilities
Enforce regulatory compliance and quality assurance
Prepare and maintain reports of credentialing activities such as accreditation, membership or facility privileges
Ensure that all information meets legal, federal and state guidelines when processing applications
Responsible for carrying out various credentialing processes in relation to physicians and allied health practitioners
Process applications for initials applicants as well as reappointments (approximately 125-200 quarterly)
Collect and process significant amounts of verification and accreditation information
Maintain and update accurate information in the Echo database (includes education, training, experience, licensure)
Prepare material for Credentials Committee meeting, MEC as well as Board of Trustees meeting
Set up and maintain provider information in Echo
Maintain confidentiality of provider information
Ensure compliance with the Bylaws at each location as it pertains to the credentialing process
Schedule, and on occasion attend and take minutes for site based medical staff department meetings
Process and collect dues for the site based medical staff
Compile and maintain current and accurate data for all providers
Track license and certification expirations for all providers
All other duties as assigned
Qualifications
Knowledge of the credentialing process required
Ability to organize and prioritize work and manage multiple priorities
Excellent verbal and written communication skills
Ability to research and analyze data
Ability to work independently
Ability to establish and maintain effective working relationships
Excellent computer skills
Verification of Credentials: Confirm that healthcare providers (e.g., physicians, nurses, therapists) have valid and current licenses, certifications, education, and training. Verify board certifications, malpractice history, and work experience.
Compliance and Regulatory Oversight: Ensure all providers meet the requirements of regulatory agencies, hospitals, and insurance networks. Maintain compliance with standards from organizations such as The Joint Commission (TJC) or NCQA.
Enrollment and Privileging: Manage applications for providers to be enrolled with insurance payers (so they can bill for services). Handle the hospital privileging process, which authorizes providers to perform specific procedures within a facility.
Record Maintenance: Maintain accurate and up-to-date credential files for each provider. Track expiration dates for licenses, certifications, and re-credentialing timelines.
Communication and Coordination: Act as a liaison between providers, HR, medical staff offices, and payers. Communicate with state licensing bodies.
Job Details
Seniority Level: Entry level
Employment Type: Contract
Job Function: Health Care Provider
Industries: Hospitals and Health Care
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Key Responsibilities
Enforce regulatory compliance and quality assurance
Prepare and maintain reports of credentialing activities such as accreditation, membership or facility privileges
Ensure that all information meets legal, federal and state guidelines when processing applications
Responsible for carrying out various credentialing processes in relation to physicians and allied health practitioners
Process applications for initials applicants as well as reappointments (approximately 125-200 quarterly)
Collect and process significant amounts of verification and accreditation information
Maintain and update accurate information in the Echo database (includes education, training, experience, licensure)
Prepare material for Credentials Committee meeting, MEC as well as Board of Trustees meeting
Set up and maintain provider information in Echo
Maintain confidentiality of provider information
Ensure compliance with the Bylaws at each location as it pertains to the credentialing process
Schedule, and on occasion attend and take minutes for site based medical staff department meetings
Process and collect dues for the site based medical staff
Compile and maintain current and accurate data for all providers
Track license and certification expirations for all providers
All other duties as assigned
Qualifications
Knowledge of the credentialing process required
Ability to organize and prioritize work and manage multiple priorities
Excellent verbal and written communication skills
Ability to research and analyze data
Ability to work independently
Ability to establish and maintain effective working relationships
Excellent computer skills
Verification of Credentials: Confirm that healthcare providers (e.g., physicians, nurses, therapists) have valid and current licenses, certifications, education, and training. Verify board certifications, malpractice history, and work experience.
Compliance and Regulatory Oversight: Ensure all providers meet the requirements of regulatory agencies, hospitals, and insurance networks. Maintain compliance with standards from organizations such as The Joint Commission (TJC) or NCQA.
Enrollment and Privileging: Manage applications for providers to be enrolled with insurance payers (so they can bill for services). Handle the hospital privileging process, which authorizes providers to perform specific procedures within a facility.
Record Maintenance: Maintain accurate and up-to-date credential files for each provider. Track expiration dates for licenses, certifications, and re-credentialing timelines.
Communication and Coordination: Act as a liaison between providers, HR, medical staff offices, and payers. Communicate with state licensing bodies.
Job Details
Seniority Level: Entry level
Employment Type: Contract
Job Function: Health Care Provider
Industries: Hospitals and Health Care
#J-18808-Ljbffr